Regional variations in heart failure: a global perspective
Heart failure (HF) is a global public health concern that affects millions of people worldwide. While there have been significant therapeutic advancements in HF over the last few decades, there remain major disparities in risk factors, treatment patterns and outcomes across race, ethnicity, socioeconomic status, country and region. Recent research has provided insight into many of these disparities, but there remain large gaps in our understanding of worldwide variations in HF care. Although the majority of the global population resides across Asia, Africa and South America, these regions remain poorly represented in epide...
Source: Heart - December 15, 2023 Category: Cardiology Authors: Yogeswaran, V., Hidano, D., Diaz, A. E., Van Spall, H. G. C., Mamas, M. A., Roth, G. A., Cheng, R. K. Tags: Review articles Reviews Source Type: research
Cochrane corner: centre versus telemedicine approaches to cardiac rehabilitation
Introduction Centre-based cardiac rehabilitation (CBCR) is typically offered to individuals post cardiac event or diagnosis to support recovery and reduce risk of future cardiovascular events. Despite strong recommendations for referral of individuals with coronary heart disease (CHD) and heart failure (HF) to cardiac rehabilitation (CR) programmes in clinical guidelines, global access remains limited, and participation remains poor. Home-based CR (HBCR) programmes, including those supported by technology and facilitated by healthcare professionals, are increasingly being used as alternative modes to CBCR in an attempt to ...
Source: Heart - December 15, 2023 Category: Cardiology Authors: McDonagh, S. T. J., Dalal, H., Moore, S., Clark, C. E., Taylor, R. S. Tags: Cochrane Corner Source Type: research
Prognostic implications of pulmonary vascular resistance in transcatheter aortic valve implantation
Pulmonary hypertension (PH) is a complex and progressive disorder characterised by elevated pulmonary artery pressure. It is a serious condition that can significantly impair quality of life and lead to fatal cardiovascular complications if left unmanaged. Transcatheter aortic valve implantation (TAVI) is a minimally invasive surgical procedure that has revolutionised the treatment of severe aortic stenosis (AS). However, the presence of PH in patients undergoing TAVI has been identified as a critical factor that can influence clinical outcomes, both in the short and long terms. In 2022, the most recent update of the Europ...
Source: Heart - December 15, 2023 Category: Cardiology Authors: Kusunose, K., Ikemiyagi, H. Tags: Editorials Source Type: research
Situational vs vasovagal syncope: one but different?
Reflex syncope is defined as a transient loss of consciousness due to a neurally mediated reflex causing sudden-onset vasodilation and bradycardia, leading to a steep decrease in blood pressure and cerebral hypoperfusion.1 According to the current European Society of Cardiology syncope guidelines, reflex syncope can be broadly classified into four groups: vasovagal syncope (VVS), situational syncope, carotid sinus syndrome and non-classical forms of syncope.1 Individuals with VVS and situational syncope are generally regarded to be at low risk of serious adverse outcomes, such as premature death, cardiac arrhythmias, pacem...
Source: Heart - December 15, 2023 Category: Cardiology Authors: Johansson, M., Fedorowski, A. Tags: Editorials Source Type: research
For Heart: the journey at the forefront of cardiovascular medicine continues
As I step into the role of Editor-in-Chief for Heart, I am both excited and honoured to lead one of the world’s most esteemed cardiovascular journals. My gratitude goes out to BMJ Publishing Group and the British Cardiovascular Society (BCS) for entrusting me with this great responsibility. I would also like to thank my predecessor, Professor Catherine Otto, and her team, who brought numerous innovations to elevate the journal’s value over the past 10 years. Building on her legacy, my goal over the coming years is to increase the impact of the journal further. Our mission at Heart is to advance scholarship in t...
Source: Heart - December 15, 2023 Category: Cardiology Authors: Rahimi, K. Tags: Editorials Source Type: research
Sleep-disordered breathing and cardiovascular disease: who and why to test and how to intervene?
Sleep-disordered breathing (SDB) is common in individuals with established cardiovascular disease (CVD), particularly those with heart failure (HF). There are two main types of SDB, central sleep apnoea (CSA) and obstructive sleep apnoea (OSA) which frequently overlap as mixed SDB. Investigating for SDB could be considered in patients with excessive daytime sleepiness, male sex, high body mass index, low ejection fraction, atrial fibrillation (AF), in patients with no dipping blood pressure pattern, recurrent paroxysms of nocturnal dyspnoea or when an apnoea is witnessed. Excessive daytime sleepiness is less likely to be r...
Source: Heart - November 27, 2023 Category: Cardiology Authors: Vazir, A., Kapelios, C. J. Tags: Education in Heart Source Type: research
Exploring the mechanisms responsible for reduced systolic function in high-gradient aortic stenosis
Conclusion
The pathophysiological problem in patients with high-gradient AS with rEF relates to an excessively increased afterload due to more severe valvular stenosis, with preserved intrinsic contractile function. Myocardial fibrosis in the rEF group did not translate into worse muscle function. (Source: Heart)
Source: Heart - November 27, 2023 Category: Cardiology Authors: Liebenberg, J., Doubell, A., Steyn, J., Herbst, P. Tags: Valvular heart disease Source Type: research
Non-COVID-19 cardiovascular pathology from return-to-play screening in college athletes after COVID-19
Conclusion
Major non-COVID-19 cardiovascular pathology was identified in 1/500 college athletes undergoing return-to-play screening. In athletes without ECG abnormalities, TTE’s added value was limited to pathological aortic root dilatation in 1/1000 athletes and minor abnormalities warranting surveillance in 1/160 athletes. Two-thirds of findings were incidental or of uncertain significance. (Source: Heart)
Source: Heart - November 27, 2023 Category: Cardiology Authors: Klein, C. F., Petek, B. J., Moulson, N., Baggish, A. L., Churchill, T. W., Harmon, K. G., Kliethermes, S. A., Patel, M. R., Drezner, J. A. Tags: COVID-19 Special populations Source Type: research
Restoration of right ventricular function in the treatment of pulmonary arterial hypertension
Conclusion
After treatment initiation, 60% of patients with PAH reach or maintain the 45% RVEF threshold, which is associated with a long-term stable RV function and favourable prognosis. (Source: Heart)
Source: Heart - November 27, 2023 Category: Cardiology Authors: Celant, L. R., Wessels, J. N., Kianzad, A., Marcus, J. T., Meijboom, L. J., Bogaard, H. J., de Man, F. S., Vonk Noordegraaf, A. Tags: Open access Pulmonary vascular disease Source Type: research
Prediction of worsening heart failure in hypertrophic cardiomyopathy using plasma proteomics
Conclusions
The present study with comprehensive plasma proteomics profiling demonstrated a high accuracy to predict worsening HF in patients with HCM and identified the Ras-MAPK and related signalling pathways as potential underlying mechanisms. (Source: Heart)
Source: Heart - November 27, 2023 Category: Cardiology Authors: Lumish, H. S., Liang, L. W., Hasegawa, K., Maurer, M. S., Fifer, M. A., Reilly, M. P., Shimada, Y. J. Tags: Editor's choice Heart failure and cardiomyopathies Source Type: research
Paired risk scores to predict ischaemic and bleeding risk twenty-eight days to one year after an acute coronary syndrome
Conclusion
We present a pair of ischaemic and bleeding risk scores specifically to assist clinicians and their patients in deciding on DAPT duration beyond the first month post-ACS. (Source: Heart)
Source: Heart - November 27, 2023 Category: Cardiology Authors: Kerr, A. J., Choi, Y., Williams, M. J., Stewart, R. A., White, H. D., Devlin, G., Selak, V., Lee, M. A. W., El-Jack, S., Adamson, P. D., Fairley, S., Jackson, R. T., Poppe, K. Tags: Open access Coronary artery disease Source Type: research
Difficult echocardiogram after pericardiocentesis
Clinical introduction A patient in their 70s, a heavy smoker with low body max index (17 kg/m2) already known for previous relapses of pericarditis on echocardiographic follow-up, was admitted for worsening pericardial effusion (figure 1A,B; ). Given initial signs of cardiac tamponade, the patient underwent urgent pericardiocentesis (subxiphoid approach) with drainage of 1500 cc of pericardial fluid, without evident complications. The pericardial catheter was kept in place for 48 hours until complete resolution of the effusion, and then carefully removed. The next-day echocardiogram was made difficult by the presence in mu...
Source: Heart - November 27, 2023 Category: Cardiology Authors: Mapelli, M., Balata, F., Lucci, C. Tags: Image challenges Source Type: research
Burden and prognostic impact of cardiovascular disease in patients with cancer
The number of patients at the intersection of cancer and cardiovascular disease (CVD) is increasing, reflecting ageing global populations, rising burden of shared cardiometabolic risk factors, and improved cancer survival. Many cancer treatments carry a risk of cardiotoxicity. Baseline cardiovascular risk assessment is recommended in all patients with cancer and requires consideration of individual patient risk and the cardiotoxicity profile of proposed anticancer therapies. Patients with pre-existing CVD are potentially at high or very high risk of cancer-therapy related cardiovascular toxicity. The detection of pre-exist...
Source: Heart - November 27, 2023 Category: Cardiology Authors: Raisi-Estabragh, Z., Manisty, C. H., Cheng, R. K., Lopez Fernandez, T., Mamas, M. A. Tags: Review articles Reviews Source Type: research
Relationship between the aortic root and the atrioventricular conduction axis
Damage to the atrioventricular conduction axis continues to be a problem subsequent to transcatheter implantation of aortic valvar prostheses. Accurate knowledge of the precise relationships of the conduction axis relative to the aortic root could greatly reduce the risk of such problems. Current diagrams highlighting these relationships rightly focus on the membranous septum. The current depictions, however, overlook a potentially important relationship between the superior fascicle of the left bundle branch and the nadir of the semilunar hinge of the right coronary leaflet of the aortic valve. Recent histological investi...
Source: Heart - November 27, 2023 Category: Cardiology Authors: Anderson, R. H., Spicer, D. E., Sanchez-Quintana, D., Macias, Y., Kapadia, S., Tretter, J. T. Tags: Review articles Reviews Source Type: research
One step closer to the new frontiers of healthcare for cardiomyopathy patients
There were great advances in the treatment of heart failure (HF) over the past decades, characterised by the inclusion of ARNI and SGLT2 inhibitors in the latest guidelines. The use of cardiac myosin inhibitors specifically for patients with hypertrophic cardiomyopathy (HCM) is also making large steps forward, which reflects the next step towards more personalised treatment.1 The increasing repertoire of treatments makes it even more important to select those patients who will benefit the most from these therapies. However, the diagnostic markers to make this selection are still limited to the usual suspects: left ventricu...
Source: Heart - November 27, 2023 Category: Cardiology Authors: Hazebroek, M. R., Verdonschot, J. A. J. Tags: Editorials Source Type: research
